Goro Ishikawa

Primary malignant melanoma of the oral cavity in japan. With Special Reference to Mucosal Melanosis

This paper is a review of 120 cases of primary malignant melanoma of the oral cavity occurring in the Japanese. We have collected 18 cases from our own department and the remainder from the literature. Since malignant melanoma arising from the oral mucosa and ectopic pigmentation are relatively common in Japan, an assumption has grown as to a possible relationship to histogenesis. The analysis of the material and the discussion are focused on these points. Malignant melanoma of the oral cavity is not rare in the Japanese. Some of the cases do not seem to have any relation to oral melanosis, but almost two‐thirds of the cases were found associated with it (36.2% of melanoma was associated with pre‐existing melanosis, and 29.8% with concurrent or later‐developing melanosis). The biological behavior and histologic patterns of these melanoses were similar to those of lentigo maligna of the skin. The pre‐existing melanoses seemed to be the most common precancerous lesion of the oral mucosa as far as malignant melanoma was concerned.

Adenoid squamous cell carcinoma of the oral mucosa. Report of two autopsy cases

Two autopsy cases of adenoid squamous cell carcinoma of the oral mucosa proper are presented. Consecutive histologic examinations confirmed that adenoid transformation had occurred directly from within the pre‐existing usual squamous cell carcinoma during the course of the disease. The adenoid pattern was reproduced in the lymph node metastases in both cases. The behavior and autopsy findings were not significantly different from those of usual squamous cell carcinoma of the oral mucosa.

Crystalloids in salivary duct cysts of the human parotid gland

Crystalloids found in salivary duct cysts of the human parotid gland were examined by scanning electron microscopical observations with electron probe X-ray microanalysis. The cystic spaces were filled with numerous crystalloids which had a variety of forms with slight eosinophilic and glassy appearance. Scanning electron microscopically, crystalloids were hexagonal and rhombohedral in shape, and cutting the surface showed a polycyclic structure or regular parallel lamination. By electron probe X-ray microanalysis, sulphur was the only detected element. The present study suggests that crystalloids resulted from deposition from supersaturated saliva containing sulphur containing compounds into the cystic lumen or into epithelial cytoplasm.

A Histopathological Study of Odontogenic Tumors

About 160 cases of odontogenic tumor were studied histologically and a classification of the odontogenic tumor was presented. No clear‐cut example of melano‐ameloblastoma, odontogenic sarcoma, ameloblastic neurinoma, dentinoblastoma was observed in this study.

Experimental autoallergic sialadenitis in mice

Experimental autoallergic sialadenitis was induced in SL/Ni mice by one or two injections of syngeneic submandibular gland homogenate emulsified with adjuvant. Light microscopically, there were marked lymphoid cell infiltration in the submandibular glands with high incidence and proliferation of duct epithelia. Furthermore complete alteration of whole glandular lobules in some cases was observed. Ultrastructurally, small and medium sized lymphocytes and plasma cells constituted a major portion of the infiltrating cells, and lymphocytes were frequently observed inside the basal lamina of ductal and acinar regions, especially observed in the small ductal region. In the aggregates of infiltrating cells, the cell remnants of salivary gland epithelia were scattered. Furthermore some of the epithelial cell remnants in aggregates of infiltrating cells could be recognized as epithelial masses which were composed of proliferated duct epithelial cells, though no typical structure of epimyoepithelial islands seen in Sjögrens syndrome was found. Anti-salivary duct antibody was detected in only one case.

Frequency and Distribution of Mucous Cells in Human Parotid Glands

ヒトの耳下腺は一般に漿液性の腺として認められているが, 新生児で導管部に粘液細胞の存在することは知られている。また, 唾液腺に原発する粘表皮腫は大・小の唾液腺のうちでも耳下腺に最も多い。正常のヒト耳下腺導管上皮に時に粘液細胞が存在することから, 粘表皮腫は唾液腺の導管上皮に由来するのであろうと考えられている。しかし, ヒト耳下腺における粘液細胞の出現頻度や分布状態などを詳細に系統的に検索した報告はほとんどみられない。本研究では, 剖検例より得た耳下腺380例について, 耳下腺組織内にみられた粘液細胞の出現頻度や出現部位などについての検索を行った。粘液細胞は検索例全体の約30%にみられ, 新生児と高年者に比較的多かった。出現部位は導管系, ことに葉間と小葉間の導管部に比較的多くみられた。また, 導管系で粘液細胞の出現をみた例の約72%で, 粘液細胞出現部導管周囲にリンパ性細胞浸潤をみたが, 基礎疾患との間には特別の関係は見出し得なかった。

Tumors of the Salivary Glands in Children

小児における唾液腺原発上皮性腫瘍の病態あるいは組織像を成人例と対比し, あわせて全唾液腺原発上皮性腫瘍中での比率または組織型などについて欧米での報告例と比較検討を行った。検索対象症例は, 38年間に東京医科歯科大学口腟病理学教室で扱った10例である。腫瘍摘出時の平均年齢は12.7歳で, 女児6例であった。発現部位は口蓋が6例で最も多く, 全体の半数以上を占めていた。組織型別には, 多形性腺腫9例と粘表皮腫1例であった。組織学的には, いずれも成人例に比して著しく相違した所見は明らかでなかった。小児における唾液腺腫瘍の頻度は同一期間中に当教室で扱った全唾液腺原発上皮性腫瘍496例の2.1%に相当し, これは欧米での数値とほぼ同様であった。組織型別には多形性腺腫は249例の3.6%に相当し, 粘表皮腫は46例の2.2%であった。

Nodular Fasciitis of the Oral Region

結節性筋膜炎の口腔領域にみられた5例を述べた。2例は口蓋舌に発生したものだが, 口腔粘膜部の結節性筋膜炎は稀であり, 従来の報告例も4例しかない。3例は顎下部に咬筋筋膜と関連して発生した。結節性筋膜炎の本邦での報告はまだ少ないので, 自験例の報告と合わせて文献的考察, 鑑別診断についても記載した。

AN AUTOPSY CASE OF PEMPHIGUS VULGARIS COMPLICATING A FATAL STRONGYLOIDIASIS

An autopsy case of fatal strongyloidiasis in a patient with pemphigus vulgaris receiving long‐term administration of corticosteroids was presented. There might exist a subclinical stage of 26 years between the acquisition of infection and the appearance of its severe symptoms. It is suggested that the long‐term administration of corticosteroids and debilitating diseases increase the pathogenecity of Strongyloides stercoralis by autoinfection, and that fatal strongyloidiasis could be a possible complication of treatment with corticosteroids.

LYMPHOSARCOMA OF JAWS RESEMBLING BURKITT'S TUMOR

Six cases of lymphosarcoma originating as primaries in the jaws were selected from biopsy and autopsy materials of the Department of Oral Pathology, Tokyo Medical and Dental University, from 1963 through 1970. These cases are recognized as an unusual lymphosarcoma syndrome characterized by primary occurrence in the jaw bones, principally of children, the frequency of multiple origin from the molar regions, the relative infrequency of peripheral lymphadenopathy, the monotonous infiltration of undifferentiated lymphoid cells with the frequent appearance of a “starry sky” pattern, and a fulminant fatal course. These clinical and histological findings resemble those of poorly differentiated lymphosarcoma of Burkitts type.